| NPI | 1700397825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 11022510A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.1300114) |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2022-07-28 |